The bill amends Section 35-17-1 of the General Laws, focusing on improving the accuracy of financial planning and budgeting for medical assistance expenditures and public assistance caseloads. It requires the state budget officer, the house fiscal advisor, and the senate fiscal advisor to meet in open public meetings for caseload estimating conferences, with a rotating chairpersonship to prevent the same individual from presiding over two successive conferences on the same subject. State agencies must participate and provide relevant input. The bill also mandates that the department of human services and the department of behavioral healthcare, developmental disabilities, and hospitals submit monthly data on forecasted costs, actual caseloads, and expenditures, including detailed reporting requirements on various assistance programs and medical assistance categories.

Furthermore, the bill outlines the responsibilities of the health insurance commissioner, such as conducting public hearings, making recommendations, and ensuring transparency in healthcare insurance operations. An advisory council will be established to represent various stakeholders and issue an annual report. A subcommittee will address issues between healthcare providers and health plans, focusing on standardizing processes and improving patient access to information. A workgroup will submit recommendations for streamlining healthcare administration, including the adoption of electronic eligibility and coverage verification standards. The bill also includes provisions for the protection of payors' ability to use code edits for fraud detection. The Office of the Health Insurance Commissioner is tasked with reporting on healthcare topics, developing guidelines, and analyzing the impact of health insurance provisions on premiums and access. The bill requires comprehensive assessments of social and human service programs and mandates the governor to appropriate recommended rates in the annual budget, with the general assembly appropriating funding for the required analyses, reports, and studies. The act would take effect immediately upon passage.

Statutes affected:
2553: 35-17-1, 42-14.5-3